单侧唇裂继发畸形的整复

Reconstructive Techniques for the Repair of Secondary Defect of Unilateral Cleft Lip

目的探讨单侧唇裂术后继发畸形的整复方法。方法充分游离口轮匝肌;行鼻小柱皮瓣切口,充分游离两侧鼻翼软骨,将患侧鼻翼软骨内脚切断上提与健侧等高后悬吊固定;菱形去除患侧鼻底部分皮肤表皮,沿创缘向下垂直切开达骨膜面,形成菱形组织瓣,衬垫于鼻底深部组织充分松解后腔隙,结合鼻翼脚处V-Y或Y-V成形矫正鼻底过宽和鼻翼脚外展。结果术后外形改善明显,效果稳定。结论口轮匝肌的完全复位与功能重建在畸形修复中有着重要作用。传统方法整复加自体或人工材料充填能有效改善畸形,效果满意。

Objective To evaluate the different techniques for the repair of secondary defect of unilateral clifl lip. Methods The incision line was designed along the nasal column and the alar cartilage was dissected. The inner crus of nasal alar were cut and fixed at same height with normal side. A part of epithelium of the nasal base was removed and a rhombus flap was formed. It was put into deep cavity of nasal base. The wide nasal base and abduct crus of nasal alas were corrected by V-Y or Y-V advanced flaps. Results Satisfactory results were achieved in all 29 patients with this technique. The post-operatlve scar was inconspicuous. Conclusion This technique with advantages of replacement of oral orbicular muscle and its functional reconstruction is a good choice for the repair of secondary defect of unilateral cleft lip.